John Stephen Autry Valid NPI

Individual provider · Marriage & Family Therapist · Blackshear, GA

NPI

1619002003

Type

Individual (Type 1)

Primary specialty

Marriage & Family Therapist

Specialty group

Behavioral Health & Social Service Providers

Taxonomy code

106H00000X

License number

MFT000386 (GA)

Sex

Male

Sole proprietor

Yes

Enumerated

2007-02-23

Last updated

2007-07-08